Involvement of vestibular organs in idiopathic sudden hearing loss with vertigo: An analysis using oVEMP and cVEMP testing

• We investigated the extent of vestibular lesions in idiopathic sudden hearing loss (ISHL) with vertigo using cervical and ocular vestibular evoked myogenic potential (cVEMP, oVEMP) testing and caloric testing.
• The percentage of abnormal responses in patients with ISHL with vertigo was highest in the cVEMP test, followed by the oVEMP and caloric tests.
• The vestibular end organs closest to the cochlea tended to be preferentially affected in ISHL with vertigo.

ObjectiveTo investigate the extent of vestibular lesions in idiopathic sudden hearing loss (ISHL) with vertigo.MethodWe reviewed the clinical records of 25 consecutive new patients with ISHL with vertigo. We classified patients based on their pattern of vestibular dysfunction. All patients showed cochlear damage and were labeled C (cochlear) type. If a patient showed abnormal cervical vestibular evoked myogenic potential (cVEMP), ocular VEMP (oVEMP) or caloric responses, an S (saccule), U (utricule) or L (lateral semicircular canal) respectively was added to their label.ResultsAll patients underwent cVEMPs and caloric tests. Sixteen (64%) and 13 (52%) showed abnormal cVEMPs and caloric responses, respectively, on the affected side. Among the 23 patients who underwent oVEMPs, 10 (43%) showed abnormal oVEMPs on the affected side. Of these 23 patients, 6 (26%) were classified as C type, 4 (17%) as CS type, 1 (4%) as CL type, 1 (4%) as CSU type, 2 (9%) as CSL type, 1 (4%) as CUL type, 8 (35%) as CSUL type.ConclusionThe vestibular end organs close to the cochlea tended to be preferentially affected.SignificanceIt is likely that vestibular dysfunction extends from organs close to the cochlea to those further from the cochlea.